Being a man in the United States means living a shorter life than in Europe or in other industrialized countries, according to a new health study.

Among 17 high-income nations studied, the U.S. finished at the bottom when it comes to life expectancy of males. American men on average live about four fewer years than those in Switzerland, which was ranked first. Women in the U.S. also ranked near the bottom for life expectancy (16th).

According to a panel of experts convened by the National Institutes of Health, the U.S. is at or near the bottom in at least nine health-related indicators. These included infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, homicides, and rates of disability.

The report attributed two-thirds of the discrepancy of life expectancy for men to American males dying before the age of 50. These early deaths were due, to a great extent, to car accidents, gun violence, drug overdoses and alcohol abuse. The U.S. also had the highest rate of poverty of the 17 countries studied and a large population of people who are uninsured.

“Although the new findings offer a uniquely comprehensive view of the problem, the fact is that U.S. citizens have for decades been dying at younger ages than those in nearly all other industrialised countries,” according to Carey L. Biron of the Inter Press Service. “The committee looked at data going back to the 1970s to note that such a trend has been worsening at least since then, with women particularly affected.”